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The struggle to get enough nutritious food could be far worse than previously understood, according to a new study examining the intersection between hunger and the types of foods found at nearby stores.

Researchers from The Ohio State University surveyed more than 650 households near a major—and economically and racially diverse—city corridor in Columbus, Ohio, to learn more about their access to food and particularly to healthful foods. They made an effort to identify representative households in terms of race, age, gender, and household income.

"Almost a third of the households were food insecure, and more than 16% had very low food security, meaning they were skipping meals, at risk for experiencing hunger and probably missing work and school and suffering health problems as a result," says study lead author Michelle Kaiser, PhD, an assistant professor of social work at Ohio State. The study appears in the Journal of Hunger & Environmental Nutrition.

"Previous estimates based on county-level census data would have suggested about half as many households didn't have enough food or adequate access to food," she says.

Households that experience food insecurity have insufficient access to quality food, periodically don't have the means to adequately and healthfully feed themselves and often rely on foodbanks and other sources for food.

Of 663 households surveyed by the Ohio State researchers, 26% were not at all satisfied with their ability to easily access food and 27% said it wasn't easy to find fresh fruits and vegetables, even though most of those surveyed (86%) said nutritional value was "important" or "very important" to them when shopping. Overall, 32% of the households had low or very low food security. The survey included about 1% of the households in the neighborhoods included in the study area.

In addition to the survey, the researchers audited 90 stores where people from those households shopped. They looked at prices and compared the items on the stores' shelves and in their coolers and freezers to the U.S. Department of Agriculture's Thrifty Food Plan and MyPlate recommendations. The food plan specifies low-cost foods to provide adequate nutrition and is the basis for the federal Supplemental Nutrition Assistance Program (SNAP). MyPlate provides nutritional guidance and stresses the importance of fruits, vegetables, whole grains, and healthy proteins.

Most people surveyed in the study shopped at a supermarket, but most also shopped at other stores close to their home regularly. For those with food insecurity, that mostly meant carry-outs, corner stores, and businesses such as drug stores that house partial markets.

Those stores may have some fruits and vegetables and other wholesome foods, but the offerings are quite limited, Kaiser says.

"In a lot of cases, this is where people are going to buy their food on a regular basis because that's the store they can get to," she says.

Traditional full-service grocery stores are increasingly pulling out of low-income areas and it's rare for a company to choose to locate a new grocery inside the city, particularly near areas with the highest poverty, Kaiser says.

"This study exposed the vastly different experiences of people who all live in the same city," Kaiser says. "My suspicion is that most people don't recognize that there are such discrepancies and can't imagine living where they couldn't easily go to a grocery store."

Previous research has shown increases in depression, social isolation, and anxiety among food-insecure residents, she says.

The good news is that there are initiatives that are showing promise, including efforts to give incentives to corner store owners for providing more produce and other nutritious foods, Kaiser says. Other policy options including looking for ways to entice grocery stores to locate in low-income, low-access neighborhoods and assuring that SNAP benefits align with nutrition recommendations, she says.

The next step in the research will include other neighborhoods in Columbus in an effort to better understand the experiences of households in neighborhoods where more immigrants and Latinos live.

Though the study looked exclusively at Columbus, Kaiser says she suspects similar disparities would be found in other metropolitan areas.